| NPI | 1134857543 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LACHANDRA CHANTE GUMS Owner/Ald 651-890-7649 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3104A0630X Assisted Living Facility, Assisted Living, Behavioral Disturbances |
| Enumeration Date | 2022-08-12 |
| Last Update Date | 2022-08-15 |